Ms Mary R Clark, FNP, CNM is a medicare enrolled "Nurse Practitioner - Family" in Point Reyes, California. She went to University Of California, San Francisco School Of Medicine and graduated in 1995 and has 31 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice La Clinica De La Raza Inc and her current practice location is
3 Sixth Street, Point Reyes, California. You can reach out to her office (for appointments etc.) via phone at
(415) 663-8666.
Ms Mary R Clark is licensed to practice in California (license number 8074) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1598918690.
Provider's Profile
| Full Name | Ms Mary R Clark |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 31 Years |
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| Location | 3 Sixth Street, Point Reyes, California |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Ms Mary R Clark attended and graduated from University Of California, San Francisco School Of Medicine in 1995
NPI Data:
- NPI Number: 1598918690
- Provider Enumeration Date: 11/03/2008
- Last Update Date: 11/03/2008
Medicare PECOS Information:
- PECOS PAC ID: 5395907018
- Enrollment ID: I20120425000557
Medical Identifiers
Medical identifiers for Ms Mary R Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1598918690 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 8074 (California) | Primary |
| 176B00000X | Midwife | 1140 (California) | Secondary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| La Clinica De La Raza Inc | 1557258282 | 130 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Mary R Clark allows following entities to bill medicare on her behalf.
| Entity Name | La Clinica De La Raza Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1538181482
PECOS PAC ID: 1557258282
Enrollment ID: O20040227001016 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Mary R Clark is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ms Mary R Clark, FNP, CNM
Po Box 910,
Point Reyes, CA 94956-0910
Ph: (415) 663-8666 | Ms Mary R Clark, FNP, CNM
3 Sixth Street,
Point Reyes, CA 94956-0910
Ph: (415) 663-8666 |
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